Hello everyone, and welcome to our case scenario for the AFib Ablation Registry for the month of April 2025. This month, we will be discussing the coding of start and end time when an LAAO procedure is performed as a concomitant procedure during the same lab visit. Our documentation is as follows. Mr. Lee was admitted for a planned AFib ablation and LAAO procedure to be performed during the same lab visit. The AFib ablation procedure is performed first, with the LAAO procedure taking place right after the ablation procedure is finished. Procedure details documented in the procedure log are as follows. Patient enters procedure room at 9.05. Anesthesia start at 9.15. Right femoral venous access established at 9.30. Ablation procedure completion time documented at 12.00. LAAO procedure started documented at 12.10. Operator breaks scrub at 14.00. Both procedures are performed successfully, and Mr. Lee is discharged home the following day. Our first question, based on the documentation provided and the two procedures taking place during the same lab visit, how is procedure start time sequence 7000 coded? Number one, patient enters procedure room at 9.05. Number two, anesthesia start at 9.15. Or number three, right femoral venous access established at 9.30. Please take a moment to review the documentation and question before making a final selection. The answer is number three, right femoral venous access established at 9.30. Since the AFib ablation procedure took place prior to the LAAO procedure, the coding instruction for code procedure start date time does not change. Based on the data dictionary procedure start date time, it's defined as the time that the skin incision, vascular access, or its equivalent was made in order to start the procedure. Our second question, based on the documentation provided, how is procedure end time sequence 7005 coded? Number one, ablation procedure completion time documented at 12.00. Number two, LAAO procedure started documented at 12.10. Or number three, operator breaks grub at 14.00. Please take a moment to review the documentation and question before making a final selection. The answer is number one, ablation procedure completion time documented as 12.00. Since another procedure was performed after the ablation procedure was completed, the definition of end time changes. Procedure end time will be coded with the time documented as the ablation procedure being completed or stopped. If the ablation procedure completion time was not documented, we can also use the LAAO procedure start time of 12.10. Additional information to consider. Based on CMS procedure coding, these two procedures are being performed during the same lab visit more often. If the LAAO procedure is performed prior to the ablation procedure, code the procedure start time, sequence 7000, as the documented time the LAAO procedure was completed or the time the documented ablation started. Code the procedure end time, sequence 7005, as indicated by the data dictionary, the time the operator completes the procedure and breaks grub at the end of the procedure. All intra-post procedure events that occur after the AFib procedure start date and time are collected when the target value, start of the procedure, and the next procedure or discharge is met. We thank you for taking the time to review our latest case scenario.

atrial fibrillation

symptoms

coding

AFect questionnaire

documentation

AFib Ablation Registry

LAAO procedure

coding guidelines

start and end times

femoral venous access